Pathophysiology oropharynx and esophagus

Question 1

Zenker’s diverticulum info, presentation, labs/diagnositics, treatment

Answer 1

• Benign structural disease
• Outpouching of lower oropharynx from muscle wall defect
• Unpredictable and may occur at any age
• Dysphagia
• Haltosis
• Detect with EGD (upper endos)
• surgical diverticuloctomy

Question 2

Cervical osteophytes info, presentation, labs/diagnositics, treatment

Answer 2

• benign structural disease
• rare, osteophytes narrow oropharynx
• usually have history of arthritis or neck surgery

Question 3

Cricopharygeal ring and HTN

Answer 3

cricopharyngeal muscle is dipslaced or fails to relax –> UES is compressed.
- dysphasia

Question 4

Neuomuscular diseases

Answer 4

dysphagia due to ALS, parkinson’s, muscular dystrophy (treat underlying cause, speech / swallow therapy, may require percutaneous endoscopy grastronomy tube)

Question 5

GERD what is it and risk factors

Answer 5

• reflux of gastric juice into esophagus
• very common; more common in obeses
• risk factors: high fat diet, caffeine, alcohol. tobacoo, medications (narcotics, antidepressants)
• causes

Question 6

GERD causes

Answer 6

• HCL&raquo_space; pepsin, bile, pancreatic enzymes
• impaired esophageal peristalsis
• inappropriate LES relaxation
• Hiatal hernia
• gastric surgery, dysmotility or obstruction
• rare Zollinger-Ellison, Sjogren’s Scleroderma

Question 7

GERD presentation

Answer 7

• Heartburn - burning sensation, substernal or epigastric, rises in chest
• often post prandial (after meals) especially large / fatty or nocturnal
• may be positional (worse lying down)
• Regurgitation with acid taste
• Rare: wheezing, stridor, hoarseness